The ‘Longevity’ Stuff I’m Not Doing

I spend a fair amount of time thinking about my longevity and healthspan. Not because I’m particularly interested in living to 110, but because I want as many healthy and capable years as I can get. I ‘exercise’ almost every day. That could be running, lifting, walking, cycling, climbing, or rowing.

I pay attention to my aerobic fitness, muscle mass, metabolic health, sleep, blood pressure, lipids, and a reasonable number of laboratory markers. Based on my office and personal experience, I understand what remaining active and capable requires, and I’m willing to put time and effort into preserving my health and physical capacity.

But… there’s so much noise and, frankly, BS on various platforms that I felt it was time to run through some of what influencers and others are promoting.

When I sat down and thought about it, it seems that I have an increasingly long list of things I’m not doing. I felt that this was worth discussing because ‘longevity’ has become an enormous industry, and industries need products to sell.

Walking, lifting weights, sleeping well, maintaining your aerobic fitness, controlling your blood pressure, not smoking, and eating reasonably well are difficult things to package into a monthly subscription. Whereas an infusion, supplement, a 1000+ biomarker panel, or a test that tells you how quickly you’re aging is considerably easier to monetize… but are any of them worth the effort or your money?

This doesn’t mean everything I discuss below is completely useless. Some are based on fascinating science, and some have plausible mechanisms. A handful might have encouraging preliminary data, and a few may eventually prove to be important. I’m certainly willing to change my mind as better evidence emerges... that’s science.

But interesting biology and a plausible mechanism are very different than evidence that an intervention helps a healthy human live longer or remain healthier.

So this isn’t a list of things I think are nonsense. It’s a list of things that haven’t yet produced enough evidence to earn anything more than my brief attention and study… At this stage, they don't warrant me spending my money or my willingness to accept risk.

NAD biology is fascinating. Nicotinamide adenine dinucleotide is involved in cellular energy metabolism, DNA repair, and numerous signaling pathways, and NAD levels appear to change with aging. That makes it an interesting target for aging research. It has also created a profitable market for NAD infusions and NAD-boosting supplements long before we’ve established that raising NAD levels in healthy humans meaningfully improves healthspan or lifespan.

We’ll see this pattern again and again in this piece. We identify something that changes with aging, and we discover that we can potentially manipulate it. Then, somewhere along the way, the ability to change a biomarker gets confused with evidence that changing it improves an outcome we care about. Those are not the same thing. Show me convincing evidence that raising NAD in a healthy person meaningfully improves physical function, reduces disease, preserves cognition, or meaningfully affects how we age, and I’ll reconsider.

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For Members, I'll cover 10 more longevity-related trends, supplements, scans, and more that don't yet fit into my strategic plan to stay active and healthy in my later decades.